Neuroendocrine Cancer of the Lung: A Diagnostic Puzzle

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Neuroendocrine Cancer of the Lung: A Diagnostic Puzzle Jules L. Derks, MD, Ernst-Jan M. Speel, PhD, Erik Thunnissen, MD, PhD, Robert Jan van Suylen, MD, PhD, Wieneke A. Buikhuisen, MD, Marie-Louise F. van Velthuysen, MD, PhD, Anne-Marie C. Dingemans, MD, PhD Journal of Thoracic Oncology Volume 11, Issue 3, Pages e35-e38 (March 2016) DOI: 10.1016/j.jtho.2015.10.013 Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Pathological slide overview of the subcutaneous posterior thoracic wall lesion and scalp lesion from the same patient that was, after multiple revisions, classified as atypical carcinoid. Posterior thoracic wall biopsy: (A) Overview slide showing the tumor with central necrosis. (B) Organoid growth pattern with nests of large cells containing abundant cytoplasm and monotonous nuclei; no dotlike necrosis (magnification ×20). (C) Single mitosis in the center (arrow head) (magnification ×40). (D/E) Positive immunohistochemical staining for Ki-67 and chromogranin-A. Subcutaneous scalp biopsy: (F) Overview slide on which slight crush artefacts are observed in the left top in a possibly less well preserved biopsy. (G) Slightly more diffuse pattern with occasional nests, showing large cells with abundant clear cytoplasm and nucleoli. No presence of necrosis (magnification ×20). (H) Single mitosis in the center (arrow head) (magnification ×40). (I/J) Positive immunohistochemical staining for Ki-67 and chromogranin-A. Journal of Thoracic Oncology 2016 11, e35-e38DOI: (10.1016/j.jtho.2015.10.013) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions